Fixing communication gaps and delivering improved population health

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Imagine having to drive across a province for hours to reach an appointment with a top specialist for a complex new medical condition that you are very concerned about. The hospital you’re going to is known for being state-of-the-art with the most advanced medical care and equipment currently available. Yet upon arrival, the specialist asks “Why are you here?” indicating that the specialist does not have access to your referral, even though you know it was completed and sent weeks earlier.

Having the latest in health technology is great, but it isn’t effective if it can’t bridge the long-standing communication gaps within our health care system.

When Canada was introduced to the electronic health record (EHR), it was initially hailed as the Holy Grail solution to the many issues rampant in our system. Yet nearly 15 years later, one issue has become clear: while EHRs serve as a critical enabling technical foundation for a fully integrated care system, they alone are not enough to drive the major changes needed in healthcare. Canada needs greater integrated efforts and innovations that leverage the foundational EHR in order to best manage an entire population’s health.

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Too often the health care system functions in reactive mode, dealing with acute patient issues as they arise, rather than delivering a complete, well coordinated and efficient long-term solution.  We are moving towards the next generation of healthcare, where patients are more actively involved in their care, wait times are reduced and the burden of chronic diseases is efficiently managed.  As we proceed, it is crucial that we combine the best of technology and human interactions, to deliver real population health management

Blending enabling technology and the human touch

It’s the heart of winter and while away on a ski holiday you’ve taken an unfortunate tumble, injuring your knee in the process. You’re rushed to a local hospital where you’re immediately assessed and treated. As the ER physician is preparing your discharge, your family physician intervenes and warns that the painkiller the ER physician is prescribing may have adverse reactions to your current medication. How is this all possible? Through the power of e-Notifications and seamless integration, your family physician was alerted to your situation. Your physician was then able to review your file electronically and pass on pertinent information to the ER Physician in a very timely manner. This is a perfect example of care continuity and the benefits it yields for both providers and patients

Focusing on care continuity, technology becomes an enabling platform that opens the lines of communication between care providers, as well as between patients and providers, so that a proper coordinated patient-centric care plan can be developed. Through active collaboration, providers can merge multiple care plans addressing different health concerns into one continuous, coherent plan. This ‘living’ plan evolves based on the changing needs of the patient and allows patients to begin making active decisions in their own healthcare.

Managing the population’s health through technology

An open line of privacy-controlled communication improves the quality and effectiveness of care across the continuum. It is an essential tool in the drive to deliver higher value healthcare. Leveraging data to stratify a population’s health risks allows providers to identify relevant gaps in care and distinguish patients with high priority conditions. It also allows them to respond to high importance situations in Public Health such as disease surveillance and emerging epidemics. Harnessing this technology allows physicians and clinicians to appropriately care for more patients than they could ever hope to in a paper-based system.

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Solutions such as e-Referral and EHR have made it possible to retire outdated and unreliable methods of communication (goodbye faxes) while improving the quality of patient data collection. However, the way in which we collect data often lacks strategic insight, direction and proper governance. For instance, data collection may only focus on a certain type of population or patient, which results in a limited or biased set of insights. The other issue that occurs is when data collection results in health insights and patient patterns that could lead to improved healthcare, but are not implemented into the system. Canada needs to put learnings into action so that the system evolves to provide more effective care for both individuals and for the population as a whole.

 

Technology is a necessary and powerful enabling tool that, when implemented and used to best effect, can provide powerful support for the care of individuals as well as managing entire populations.